A latent class analysis of dissociation and posttraumatic stress disorder: evidence for a dissociative subtype
- PMID: 22752235
- PMCID: PMC3390764
- DOI: 10.1001/archgenpsychiatry.2011.1574
A latent class analysis of dissociation and posttraumatic stress disorder: evidence for a dissociative subtype
Abstract
Context: The nature of the relationship of dissociation to posttraumatic stress disorder (PTSD) is controversial and of considerable clinical and nosologic importance.
Objectives: To examine evidence for a dissociative subtype of PTSD and to examine its association with different types of trauma.
Design: A latent profile analysis of cross-sectional data from structured clinical interviews indexing DSM-IV symptoms of current PTSD and dissociation.
Settings: The VA Boston Healthcare System and the New Mexico VA Health Care System.
Participants: A total of 492 veterans and their intimate partners, all of whom had a history of trauma. Participants reported exposure to a variety of traumatic events, including combat, childhood physical and sexual abuse, partner abuse, motor vehicle accidents, and natural disasters, with most participants reporting exposure to multiple types of traumatic events. Forty-two percent of the sample met the criteria for a current diagnosis of PTSD.
Main outcome measures: Item-level scores on the Clinician-Administered PTSD Scale.
Results: A latent profile analysis suggested a 3-class solution: a low PTSD severity subgroup, a high PTSD severity subgroup characterized by elevations across the 17 core symptoms of the disorder, and a small but distinctly dissociative subgroup that composed 12% of individuals with a current diagnosis of PTSD. The latter group was characterized by severe PTSD symptoms combined with marked elevations on items assessing flashbacks, derealization, and depersonalization. Individuals in this subgroup also endorsed greater exposure to childhood and adult sexual trauma compared with the other 2 groups, suggesting a possible etiologic link with the experience of repeated sexual trauma.
Conclusions: These results support the subtype hypothesis of the association between PTSD and dissociation and suggest that dissociation is a highly salient facet of posttraumatic psychopathology in a subset of individuals with the disorder.
Conflict of interest statement
None of the authors of this manuscript have a conflict of interest to disclose.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3390764/bin/nihms356168f1.gif)
Similar articles
-
The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1062-1072. doi: 10.1016/j.jaac.2017.09.425. Epub 2017 Oct 4. J Am Acad Child Adolesc Psychiatry. 2017. PMID: 29173740 Free PMC article.
-
The dissociative subtype of PTSD in women with substance use disorders: Exploring symptom and exposure profiles.J Subst Abuse Treat. 2019 Apr;99:73-79. doi: 10.1016/j.jsat.2019.01.004. Epub 2019 Jan 4. J Subst Abuse Treat. 2019. PMID: 30797397 Clinical Trial.
-
Psychometric Properties of the Dissociative Subtype of PTSD Scale: Replication and Extension in a Clinical Sample of Trauma-Exposed Veterans.Behav Ther. 2019 Sep;50(5):952-966. doi: 10.1016/j.beth.2019.02.003. Epub 2019 Mar 5. Behav Ther. 2019. PMID: 31422850 Free PMC article.
-
The Dissociative Subtype of Post-Traumatic Stress Disorder: A Systematic Review of the Literature using the Latent Profile Analysis.J Trauma Dissociation. 2024 May-Jun;25(3):349-365. doi: 10.1080/15299732.2022.2120155. Epub 2022 Sep 4. J Trauma Dissociation. 2024. PMID: 36062756 Review.
-
Evidence of the dissociative PTSD subtype: A systematic literature review of latent class and profile analytic studies of PTSD.J Affect Disord. 2017 Apr 15;213:59-69. doi: 10.1016/j.jad.2017.02.004. Epub 2017 Feb 7. J Affect Disord. 2017. PMID: 28192736 Review.
Cited by
-
Peritraumatic dissociation and posttraumatic stress symptoms: the moderating role of perceived threat.Eur J Psychotraumatol. 2024;15(1):2338670. doi: 10.1080/20008066.2024.2338670. Epub 2024 Apr 15. Eur J Psychotraumatol. 2024. PMID: 38618677 Free PMC article.
-
A novel theory on the predictive value of variation in the β-endorphin system on the risk and severity of PTSD.Mil Psychol. 2020 Feb 25;32(3):247-260. doi: 10.1080/08995605.2020.1730111. eCollection 2020. Mil Psychol. 2020. PMID: 38536347 Free PMC article. Review.
-
Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study.Biol Psychiatry Glob Open Sci. 2023 Feb 16;3(4):705-715. doi: 10.1016/j.bpsgos.2023.02.004. eCollection 2023 Oct. Biol Psychiatry Glob Open Sci. 2023. PMID: 37881578 Free PMC article.
-
Moral injury appraisals and dissociation: Associations in a sample of trauma-exposed community members.J Trauma Dissociation. 2023 Oct-Dec;24(5):692-711. doi: 10.1080/15299732.2023.2231010. Epub 2023 Jun 30. J Trauma Dissociation. 2023. PMID: 37387238
-
To Trust is to Survive: Toward a Developmental Model of Moral Injury.J Child Adolesc Trauma. 2021 Aug 13;16(2):459-475. doi: 10.1007/s40653-021-00399-1. eCollection 2023 Jun. J Child Adolesc Trauma. 2021. PMID: 37234829 Free PMC article.
References
-
- Carlson EB, Dalenberg C, McDade-Montez E. Dissociation in posttraumatic stress disorder: recommendations for modifying the diagnostic criteria for PTSD. Psychol Trauma. in press.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous